Name of person(s)/Organisation making the application.
If you area group,giveabriefdescriptionofit and its generalaims. Ifanindividual,supplyinformation aboutyourself(occupation,experienceand qualificationsrelevanttoyourproject.)

3.

As an applicant, do you own the land?
If no,pleasesupplyevidencethatthe ownerknows about,andagreeswith,theproposal.

YES NO

4.

Who will manage the project?
What relevant qualifications and experience does that person have?

a. Please give a brief outline of the proposed project.
(Includeinformationonwildlifeneeds;eg. embayments,nestingislands,loafing areas, slopingmargins etc.b. Area of gamebird habitat involved c. Area of water to be created

d. Water source/management

10.

What do you believe will be the habitat benefits from your project, both for your own property and the surrounding area? What are you personally, hoping to achieve?

11.

Is it expected that the completed gamebird habitat will be hunted or shot over? If ‘yes’, how many hunters could the project safely accommodate at any one time?

(d) Should the project not go ahead I shall return any money or equipment received from or provided by the Trust Board.

(e) I agree if required by the Trust Board to enter into such security documentation to protect and secure the project including (but not limited to) the Habitat Enhancement Agreement adopted by the Board, of which I have received a copy.

A report on your project by a referee independent of the agency making the application is required

– where the applicant is a Fish and Game Council it is required that the referee is someone outside of that Council. It is suggested a referee be a field officer from your local Fish and Game region or

another approved independent source like the Department of Conservation or your regional

council. If you would like to ask someone other than a Fish and Game Officer to be your referee it needs to be a person who has sufficient knowledge of you or the applicant group, and the type of project being undertaken.